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Zahir H, Arsalane L, Elghouat G, Mouhib H, Elkamouni Y, Zouhair S. Seroprevalence of rubella in pregnant women in Southern Morocco. Pan Afr Med J 2020; 35:10. [PMID: 32373261 PMCID: PMC7195913 DOI: 10.11604/pamj.supp.2020.35.1.18496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 02/06/2020] [Indexed: 11/27/2022] Open
Abstract
Rubella is a generally benign but dangerous viral infection in early pregnancy, due to the teratogenic potential of the virus. Indeed, it causes spontaneous abortions, in-utero fetal death, premature labor and congenital malformations known as congenital rubella syndrome. The purpose of this study is to determine the immune status of rubella in pregnant women in southern Morocco. A prospective, multicentre study was conducted in 2017 for the detection of rubella IgG and IgM antibodies in 380 pregnant women aged 17 to 46 years, using the Architect i1000 chemiluminescent microparticle immunoassay. Eigthy for percent (84.7%) of women were seropositive. Ten percent of multiparous women remained seronegative despite recommendations for vaccination after delivery. Preventive measures against congenital rubella need to be strengthened, and vaccination is needed in non-immunized women. Vaccination awareness campaigns, especially among non-immunized multiparous women, remain essential.
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Affiliation(s)
- Hanane Zahir
- Laboratoire de Microbiologie-Virologie et Biologie Moléculaire, Hôpital Militaire Avicenne, Centre Hospitalier Universitaire Mohammed VI de Marrakech, Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayyad, avenue Ibn Sina, BP 2360 Marrakech-principal, Maroc
| | - Lamiae Arsalane
- Laboratoire de Microbiologie-Virologie et Biologie Moléculaire, Hôpital Militaire Avicenne, Centre Hospitalier Universitaire Mohammed VI de Marrakech, Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayyad, avenue Ibn Sina, BP 2360 Marrakech-principal, Maroc
| | - Ghita Elghouat
- Laboratoire de Microbiologie-Virologie et Biologie Moléculaire, Hôpital Militaire Avicenne, Centre Hospitalier Universitaire Mohammed VI de Marrakech, Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayyad, avenue Ibn Sina, BP 2360 Marrakech-principal, Maroc
| | - Hanane Mouhib
- Laboratoire de Microbiologie-Virologie et Biologie Moléculaire, Hôpital Militaire Avicenne, Centre Hospitalier Universitaire Mohammed VI de Marrakech, Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayyad, avenue Ibn Sina, BP 2360 Marrakech-principal, Maroc
| | - Youssef Elkamouni
- Laboratoire de Microbiologie-Virologie et Biologie Moléculaire, Hôpital Militaire Avicenne, Centre Hospitalier Universitaire Mohammed VI de Marrakech, Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayyad, avenue Ibn Sina, BP 2360 Marrakech-principal, Maroc
| | - Said Zouhair
- Laboratoire de Microbiologie-Virologie et Biologie Moléculaire, Hôpital Militaire Avicenne, Centre Hospitalier Universitaire Mohammed VI de Marrakech, Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayyad, avenue Ibn Sina, BP 2360 Marrakech-principal, Maroc
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Borba VV, Zandman-Goddard G, Shoenfeld Y. Exacerbations of autoimmune diseases during pregnancy and postpartum. Best Pract Res Clin Endocrinol Metab 2019; 33:101321. [PMID: 31564626 DOI: 10.1016/j.beem.2019.101321] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Autoimmune diseases represent a complex heterogeneous group of disorders that occur as a results of immune homeostasis dysregulation and loss of self-tolerance. Interestingly, more than 80% of the cases are found among women at reproductive age. Normal pregnancy is associated with remarkable changes in the immune and endocrine signaling required to tolerate and support the development and survival of the placenta and the semi-allogenic fetus in the hostile maternal immune system environment. Gravidity and postpartum represent an extremely challenge period, and likewise the general population, women suffering from autoimmune disorders attempt pregnancy. Effective preconception counseling and subsequent gestation and postpartum follow-up are crucial for improving mother and child outcomes. This comprehensive review provides information about the different pathways modulating autoimmune diseases activity and severity, such as the influence hormones, microbiome, infections, vaccines, among others, as well as updated recommendations were needed, in order to offer those women better medical care and life quality.
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Affiliation(s)
- Vânia Vieira Borba
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - Gisele Zandman-Goddard
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Department of Medicine C, Wolfson Medical Center, Tel Aviv, Israel
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Russia.
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Sénat MV, Sentilhes L, Battut A, Benhamou D, Bydlowski S, Chantry A, Deffieux X, Diers F, Doret M, Ducroux-Schouwey C, Fuchs F, Gascoin G, Lebot C, Marcellin L, Plu-Bureau G, Raccah-Tebeka B, Simon E, Bréart G, Marpeau L. Postpartum practice: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol 2016; 202:1-8. [PMID: 27155443 DOI: 10.1016/j.ejogrb.2016.04.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/19/2016] [Accepted: 04/23/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To make evidence-based recommendations for the postpartum management of women and their newborns, regardless of the mode of delivery. MATERIAL AND METHODS Systematic review of articles from the PubMed database and the Cochrane Library and of recommendations from the French and foreign societies or colleges of obstetricians. RESULTS Because breast-feeding is associated with reductions in neonatal, infantile, and childhood morbidity (lower frequency of cardiovascular, infectious, and atopic diseases and infantile obesity) (LE2) and improved cognitive development in children (LE2), exclusive and extended breastfeeding is recommended (grade B) for at least 4-6 months (professional consensus). Pharmacological treatments for inhibition of lactation should not be given routinely to women who do not wish to breastfeed (professional consensus). Because of potentially serious adverse effects, bromocriptine is contraindicated in inhibiting lactation (professional consensus). For women aware of the risks of pharmacological treatments to inhibit lactation but choose to take them, lisuride and cabergoline are the preferred drugs (professional consensus). Regardless of the mode of delivery, only women with bleeding or symptoms of anemia should be tested for it (professional consensus). Immediate postoperative monitoring after cesarean delivery should be performed in the postanesthesia care unit (PACU). An analgesic multimodal protocol for analgesia, preferring oral administration, should be developed by the medical team and be available for all staff (professional consensus) (grade B). Thromboprophylaxis with compression stockings should begin the morning of all cesarean deliveries and maintained for at least 7 postoperative days (professional consensus) with or without the addition of LMWH, depending on the presence and severity (major or minor) of additional risk factors. It is recommended that women be informed of the dangers of closely spaced pregnancies (LE3), that effective contraception begin no later than 21 days post partum for women who do not want such a pregnancy (grade B), and that it be prescribed at the maternity ward (professional consensus). In view of the postpartum risk of venous thromboembolism, use of combination hormonal contraception is not recommended before six weeks post partum (grade B). Pelvic floor rehabilitation in asymptomatic women to prevent urinary or anal incontinence in the medium or long term is not recommended (professional consensus). Rehabilitation using pelvic floor muscle contraction exercises is recommended to treat persistent urinary incontinence at 3 months post partum (grade A), regardless of the type of incontinence. Postpartum pelvic floor rehabilitation is recommended to treat anal incontinence (grade C), but not to treat or prevent prolapse (grade C) or dyspareunia (grade C). The months following the birth are a period of transition and of psychological changes for all parents (LE2) and are still more difficult for those with psychosocial risk factors (LE2). Situations of evident psychological difficulties can have a significant effect on the child's psychological and emotional development (LE3). Among these difficulties, postpartum depression is most common, but the risk of all mental disorders is generally higher in the perinatal period (LE3). CONCLUSION The postpartum period presents clinicians with a unique and privileged opportunity to address the physical, psychological, social, and somatic health of women and babies.
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Affiliation(s)
- Marie-Victoire Sénat
- Service de Gynécologie Obstétrique Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris (APHP), Le Kremlin-Bicêtre, Université Paris-Sud, France.
| | - Loïc Sentilhes
- Service de Gynécologie-Obstétrique, CHU Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Anne Battut
- Collège National des Sages-Femmes de France (CNSF), France
| | - Dan Benhamou
- Service d'Anesthésie Réanimation Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris (APHP), Le Kremlin-Bicêtre, Université Paris-Sud, France
| | - Sarah Bydlowski
- Département de psychiatrie de l'enfant et de l'adolescent - Association de Santé Mentale du XIIIème arrondissement, Paris, France
| | - Anne Chantry
- Inserm UMR 1153, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre de recherche épidémiologie et statistique Sorbonne Paris Cité, DHU risques et grossesse, Université Paris Descartes, 75014 Paris, France; Ecole de sages-femmes Baudelocque, Assistance publique-Hôpitaux de Paris, Université Paris Descartes, 75014 Paris, France
| | - Xavier Deffieux
- Service de gynécologie-obstétrique et médecine de la reproduction, Hôpital Antoine Béclère, Assistance Publique Hôpitaux de Paris (APHP), Clamart, Université Paris-Sud, France
| | - Flore Diers
- Collectif Inter-Associatif autour de la NaissancE (CIANE), Pairs, France
| | - Muriel Doret
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Service de Gynécologie-Obstétrique, Bron, France; Université Lyon 1, France
| | | | - Florent Fuchs
- Service de Gynécologie Obstétrique Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris (APHP), Le Kremlin-Bicêtre, Université Paris-Sud, France
| | - Geraldine Gascoin
- Service de réanimation et médecine néonatale, CHU Angers, Angers, Université d'Angers, France
| | - Chantal Lebot
- Direction des ressources humaines et des écoles, CHU Tours, Tours, France
| | - Louis Marcellin
- Service de Gynécologie-Obstétrique II et Médecine de la Reproduction, Port-Royal Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes, Paris, France
| | - Genevieve Plu-Bureau
- Service de Gynécologie-Obstétrique II, Unité de Gynécologie Endocrinienne, Port-Royal Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes, Paris, France
| | - Brigitte Raccah-Tebeka
- Service de Gynécologie-Obstétrique, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Emmanuel Simon
- Service de Gynécologie Obstétrique, Médecine Fœtale. CHRU de Tours, Université François-Rabelais de Tours, Tours, France
| | - Gérard Bréart
- Inserm UMR 1153, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre de recherche épidémiologie et statistique Sorbonne Paris Cité, DHU risques et grossesse, Université Pierre et Marie Curie, Paris, France
| | - Loïc Marpeau
- Service de Gynécologie-Obstétrique, CHU Charles Nicolle, Rouen, Université de Rouen, France
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